A recent Healthcare Innovation webinar articulated how Blue Cross & Blue Shield of Rhode Island (BCBSRI) deployed an Employer Reporting solution from MedeAnalytics to empower their consultants to collaborate directly with brokers as "trusted advisors" and deliver value-added self-service analytics.
Andy Dé, vice president marketing at MedeAnalytics, kicked off the webinar by describing some of the analytics use cases being driven by current trends in healthcare —for both providers and payers.
Of course, many of today’s trends are being driven by the pandemic. Analytics are key to supply chain and revenue cycle issues, Dé said. AI and Analytics solutions can help accurately forecast demand for drugs, devices, and protective supplies for caregivers. Other use cases involve projecting the total number of hospital beds and constraint capacity and identifying and prioritizing elective procedures based on both demand and capacity.
For instance, MedeAnalytics helps providers with revenue cycle management (RCM), value based care and population health management (PHM), identifying the most vulnerable patients and segments of the community, as well as managing and optimizing costs while ensuring the highest quality of care delivery.
From a revenue cycle management (RCM) perspective, MedeAnalytics can help accelerate accounts receivable collections and reduce denials significantly to improve revenue realization. “For providers, we help them improve revenue cycle and operation performance to enable lower costs, greater efficiencies, and improve quality and outcomes,” Dé said.
Dé spoke about some of the use cases that are going to be enabled by artificial intelligence and analytics in the new normal beyond COVID-19 — proactively identifying patients with co-morbidities who are at high risk for adverse health events, enabling a 360-degree view of patients for clinicians and nurses at the patient’s bedside. “Population health stratification for chronic diseases, like cardiovascular disease, COPD, diabetes, and cancer, is probably one of the foremost areas where artificial intelligence and predictive analytics are used today,” he said.
Dé then turned to some of the data analytics and AI opportunities for healthcare payers. It is critical to understand the changing needs of patients and customers in the wake of COVID-19, he said, including how to segment and target new prospects from a risk management perspective. “How do you forecast demand for new products and services, care management and primary care in lower-cost, outpatient care settings, with telehealth engagement based on cost and convenience, and then respond proactively to the needs of high-risk and rising-risk patients based on predictive analytics?” Minimizing customer churn is obviously significant. How do you address customers through loyalty programs to protect revenues that would otherwise be lost to the competition? “Health plans must demonstrate that they have member-focused programs, including good communication practices and high satisfaction in place before approaching employers,” he said.
Health plans are under pressure to demonstrate the value of their plans to their employer clientele and brokers in order to be perceived as trusted advisors and enable loyalty retention and revenue uplift. “They need to be armed with competitive data, to be able to structure contracts and negotiate with providers,” Dé said, “and this is precisely the challenge MedeAnalytics helps address with Employer Reporting for payers,” he said. “We help payers provide employers an integrated view of the plan’s performance and deliver customized self-service reports and presentations, KPIs and metrics. Employee Reporting fundamentally provides health plans, employer groups and broker clients with actionable insights into drivers of care, cost and quality needed to improve plan performance and increase customer satisfaction, loyalty, and retention.”
Dé then introduced Angelo Pirri, manager of employer analytics at Blue Cross & Blue Shield of Rhode Island (BCBSRI), who oversees a team of information consultants providing clients with high-quality analytics that promote insight into actionable data-driven decisions.
Pirri began by describing some of the challenges BCBSRI faced over the years in its AI analytics journey. “Historically, we were not always the leader in the market when it came to data and analytics. We always had the information but lacked the well-organized data and insights you get from that,” he said. “For years, analytics for our clients meant receiving reports on a monthly basis, maybe in a PDF format, or sometimes in Excel. There was little interaction with the data and not much insights into understanding.”
About seven ago, BCBSRI started to realize that some of its competitors had superior analytic capabilities, which was driving some of their customers to them. Around 2014-2015, they began evaluating some Employer Reporting applications and in 2016 began their partnership with MedeAnalytics.
Among their goals were identifying standardization opportunities and cost savings improvements as well as building a full view of their data to create a single source of truth for brokers and clients. “Implementing an Employer Reporting solution has directly impacted these goals, exponentially enhancing productivity and allowing us to develop our skills and learn what our customers want and need,” Pirri said.
Specifically, the employer reporting solution enabled his team of information consultants to evolve from analysts and “report writers” to “trusted advisors” thanks to the actionable insights they delivered to their customers comprising employers and brokers:
- A 360-degree view that provides a “single version of the truth” for the customers
- Identify opportunities for standardization, cost savings, improvement
- Turn around reports in hours vs. weeks, contribution to higher customer satisfaction and retention
With MedeAnalytics Employee Reporting, BCBSRI has been able to reduce standard report turnaround times by 50 percent and ad hoc report turnaround times by 75 percent. Improving client satisfaction contributed to client retention and also new business wins, including $ 2.9 MM in increased efficiencies and revenue uplift, while delivering a payback on their MedeAnalytics investment in less than 12 months, Pirri said.
“Having a self-service employer analytics solution immediately changed our analytic strategy and made us competitive in the market,” Pirri said. “With decreased turnaround times and increased employee morale, our team supporting the employer segment now has the time and the tools to analyze the data, develop the insights and provide meaningful recommendations. We are now integrated in the multi-year strategy discussions with our clients and their brokers and consultants. We knew it was time to exceed the expectations of our brokers and clients and help them to proactively identify cost drivers that will assist in renewals, discussions and financial planning, regularly supporting their analytic needs as trusted advisors.”
Another BCBSRI goal was to give clients and brokers direct access to some of the data reporting and insights. “Giving our clients the ability to self-serve nearly eliminated turnaround times with some of the most standard and basic reports,” Pirri said. “They now have the ability to identify cost drivers, prepare renewal discussions and make decisions based on data that is now at their fingertips.”
Clients can work with BCBSRI information consultants on more advanced analytics and strategy discussions. “This allows our information consultants to spend more time with our clients and brokers, understand what their needs are, and what we can do for them as information consultants,” Pirri said. “There is clear value in deploying the Employer Reporting solution. For our team, we're not stopping there. We continue to grow and look for new opportunities to support all of our customers and be a best-in-class analytics team.”
